Objective To observe the clinical efficacy Yizhi Qingxin Prescription combined with warming-needle muxibustion in the treatment of vascular cognitive impairment(VCI)after cerebral infarction,and to explore its effect on cognitive function.Methods A total of 110 cases of patients with definitive diagnosis of VCI after cerebral infarction admitted to Beijing Bo'ai Hospital from February 2020 to February 2023 were selected for the study.The patients were randomly divided into a control group and an observation group according to random number table method,with 55 cases in each group.The control group was treated with Donepezil Hydrochloride,and the observation group was treated with Yizhi Qingxin Prescription combined with warming-needle muxibustion on the basis of the treatment of the control group,the course of treatment covered four consecutive weeks.After one month of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the scores of the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA),as well as the measurements of cerebral blood perfusion were observed before and after the treatment of the patients in the two groups.The changes of C-reactive protein(CRP),interleukin 6(IL-6),and tumor necrosis factor α(TNF-α)before and after treatment were compared between the two groups.The safety and incidence of adverse reactions in the two groups were also evaluated.Results(1)The total effective rate was 96.36％(53/55)in the observation group and 74.55％(41/55)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P＜0.05).(2)After treatment,the MMSE scores and MoCA scores of the patients in the two groups were improved significantly(P＜0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P＜0.05).(3)After treatment,the CBV,MTT,and CBF of the basal ganglia region of the two groups were significantly improved(P＜0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P＜0.05).(4)After treatment,the serum CRP,IL-6,and TNF-α levels of patients in the two groups were significantly improved(P＜0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P＜0.05).(5)The incidence of adverse reactions in the observation group was 7.27％(4/55),and that in the control group was 5.45％(3/55),the comparison between the two groups showed that the difference being not statistically significant(P＞0.05).Conclusion Yizhi Qingxin Prescription combined with warming-needle muxibustion in the treatment of VCI after cerebral infarction can effectively alleviate the cognitive function of patients,improve their cerebral blood perfusion,and inhibit the release of inflammatory factors,so as to enhance their quality of life.

Objective To investigate the clinical utility of keyhole craniotomy for Cholesteatmas in the cerebello-pontine angle region presenting as Trigeminal neuralgia by using keyhole craniotomy. Methods Clinical data of 35 pa-tients with Cholesteatmas in the cerebellopontine angle region presenting as Trigeminal neuralgia was analyzed retrospec-tively. All patients received suboccipital retrosigmoid keyhole craniotomy. Thirty cases who received conventional craniot-omy group were served as control group. A comparative analysis was conducted to assess the difference between these two groups in microsurgical methods, effects and complications. Results All patients were confirmed with MR diagnosis. In keyhole group, all patients had no pain symptoms of trigeminal neuralgia after surgical operation. The symptoms disap-peared immediately in 33 cases and gradually disappeared in 2 cases within one month following keyhole craniotomy. The tumors were totally removed in 25 cases and almost completely in 10 cases. The surgical duration was shorten in key-hole group than in conventional group (126±48 vs. 216±66 min;t=2.536, P<0.05). The amount of bleeding was smaller in keyhole group than in conventional group (91.3±52.2 vs. 186.3±65.4 mL;t=2.163, P<0.05). Postoperative neurologi-cal function was assessed in House-Brackmann. In keyhole group, there were 32 cases in class Ⅰ and 3 in grade Ⅱ. Two patients had hearing loss which was improved gradually in three months. In conventional group, there were 25 cases in class Ⅰ and 5 in grade Ⅱ (χ2=4.158, P<0.05). Postoperative hearing evaluation (AAO-HNS) revealed that there were 33 cases in grade A , and 2 in grade B in the keyhole group, whereas there were 27 cases in grade A and 3 in grade B in the conventional group(χ2=5.167, P<0.05). There were no relapse of tumors and death during 3 month to 5 years follow-up. Conclusions The suboccipital retrosigmoid keyhole craniotomy is a valid choice for Cholesteatmas in the cerebellopontine angle region presenting as Trigeminal neuralgia.